Well I completed all of the reading and exercises for the first section of my Healthcare Informatics program and was ready to take the test. Now, having not taken a college exam for over 26 years I must say I was quite anxious about this. It was not like taking a CEU course and then taking the post test 3-4 times until you get the answers all correct. This was an actual college exam that was going to grade the knowledge you had gained over the last few weeks of reading.

I must say I was surprised once I accessed the exam to see how much I had retained from what I read. As an older learner I was prepared for some struggle. Did I use the book as I was permitted? Yes, but I found that I used it to confirm my answers not find them and that was a good feeling. I know that there will be struggles in this course and concepts that I will need to dissect and rebuild in my mind to be able to grasp them. However, I now know that I am able to grasp new ideas and content and use this knowledge, which will help me to apply it in the practical use of my job.

This was a day of firsts for me. It was the kick off of my first solo project as a “new” project coordinator and clinical informaticist. It was my first college exam on my quest to obtain my BSN and Healthcare Informatics Certificate. The first is often the hardest and sometimes the most rewarding and … it feels good.

I do think having having thing available electronically is very helpful, but at the same time I do not.The doctor may read what you have written him in an email but may not completely understand it. It is good to have oral communication available if need. If he were to have a question, he could call you but having a person right there in front of you is much easier I believe. Everything is becoming electronic now and days, so I better start getting used to it.

We encounter standards everyday in our lives. From traffic lights, traffic signs, telephone key pads, keyboards, postal envelopes and paper sizes to the many areas of construction such as sizes of appliances, tools, wood, windows, and the list could go on. So, why are standards established? The term standard is defined as an established norm or requirement; it establishes uniform or technical criteria, methods, processes, and practices. Standards enhance the capability to improve production and decrease costs associated with creating the end product. By establishing standards this enables companies to increase workflows and efficiencies. When a customer or end user learns the rules or knows the standards, this allows them to become proficient and knowledgeable in the use of the tool or issue at hand. For instance, when a person drives to another state, the traffic signs and signals are the same or standardized across the nation. One does not need to re-learn traffic signs for every different place they drive. Established standards that are implemented and followed in health care environments increases the quality of care, workflow processes, saves the organization money, and ultimately improving patient safety and patient outcomes. Benefits and improvements affecting the delivery of care will be evident when standards are adopted internally by health care organizations, whether developed for the betterment of the organization or by regulatory agencies. Process improvements will be identified with the implementation of standards. Obtaining high quality data and information and maintaining the integrity of the data comes from using recognized standards. As the implementation of the electronic health record is an initiative and included in strategic plans in many health care organizations today, standards are necessary. Defining standards will assist in improving the extremely complex arena of health care data, information, and information management.

Sometimes at work I feel like such a nerd. I have actually been called one due to the knowledge base that I possess at this time. At meetings, I will explain in detail some of the technologies, barriers, processes, etc. I watch nurse administrators eyes glaze over as I speak. It is very interesting to consider the scope of Informatics. By definition, informatics is the science of information. This in turn is defined by Webster’s as the collection, classification, storage, retrieval, and dissemination of recorded knowledge treated both as a pure and as an applied science; quite a mouthful.

Needless to say, the scope of informatics is very broad. The fields include nursing informatics, pharmacy informatics, medical informatics, lab informatics, radiology informatics, etc. It can range from the tools utilized to the Project Design and Management. It is an ever growing field with much diversity, challenge and opportunity for professionals.

Back to my nerdness; approximately one year ago, my CNO called me a nerd because I was able to download an application and run a DVD off of a laptop. Not that complicated but leads to the understanding that there are differing levels of competency in regards to informatics and technology.

This led me to volunteering for a Technology Informatics Guiding Education Reform (TIGER) workgroup to develop informatics competencies for entry into the acute care hospital setting. This has been a very exciting and collaborative process and will support the institutions in providing entry level orientation to the technologies used on a day to day basis.

My current job description has informatics incorporated into it and I hope to become the Project Manager on the upcoming Pharmacy Pyxis MedStation project. However, reviewing the job postings at the different sites has inspired me to evaluate what I am currently doing and determine what I want to do with my informatics knowledge.

A few years ago, I came to the decision to change my focus from providing for the patients and their families to providing for the nurses. The assessment of my institution clearly has defined the need for a Clinical Informaticists to support the nursing staff in their move forward with EHR, eMAR, clinical documentation, Smart Pumps, Medication Stations, etc. The support would include implementation, initial education, ongoing education, and updates. It is all very exciting.

As I learn and grow within this field, I have determined that being a nerd is not so bad. Actually, I take it as a compliment; it means that I have been recognized as having a body of knowledge and I have been called upon frequently to use this knowledge base. I wonder if that could be a certification – NN, Nerd Nurse.

HCI is the study of interaction between people and computers. Interaction between users and computers occurs at the user interface, which includes both software and hardware. According to the Association for Computer Machinery, HCI is concerned with the design, evaluation, and implementation of interactive computer systems for human use and with the study of major phenomena surrounding them. In the healthcare environment, and specifically implementing and electronic medical record (EMR), it is important to understand HCI to ensure the users and the computers interact successfully. The goals of HCI are to deploy usable, safe, and functional systems. Developers must try to understand how people use technology in order to produce computer systems used by their intended audience, which will improve the collection of accurate data. Consulting with the end users is important in gaining the understanding of their needs. Also, maintaining the involvement of the end user will often result in an increased acceptance of the new process or new system to be used. When evaluating the computer system, identifying the appropriate end user is important. Receiving feedback from someone who will interact with the interface on a daily basis is a good resource. Tasks the users will be performing and how often these tasks will be performed, need to also be defined. Measurements should be established, such as the number of users performing the tasks, the time it takes to complete the tasks, and the number of errors made. Once these evaluation procedures are in place, a system can be designed and tested. After the initial testing, the interface should be analyzed using the same established evaluation criteria. The developers should make changes where necessary as identified from the analysis of the testing, then, repeat the testing and evaluation process until an acceptable user interface is developed. Designing health care information systems utilizing HCI methodologies and usability resources is a critical aspect of increasing patient safety. Well designed computer interfaces and systems allow for correct data entry, understanding the display of information, and assisting with making skillful clinical decisions, which results in reduced errors. Additionally, using HCI concepts ultimately has a positive return on investment to the organization by identifying time needed to complete tasks, time needed to train staff, and the level of support staff involvement. Utilizing these concepts will result in reducing the end users frustration with the system and increases their productivity. Studies prove the benefits and the value of using HCI concepts in developing computer systems. As healthcare organizations implement EMRs, it is imperative to understand the need for human factors in developing computer systems to ensure their systems and their users work together effectively and efficiently.

I used to work for Children’s Hospital in the IMU unit. Many times, we as nurses would encounter many genetic disorders that were foreign to us or we just did not know enough about the disorder to help educate their parents. Since I also took classes in genetics, I found myself digging further into a particular website OMIM. This website was extremely useful in providing information on genetic diseases and compiled all the information and studies on each genetic problem. This was useful because if children were not reaching their physical or emotional development, many times this was addressed within the study and what was “normal” for that disease process. Many families were at a loss and just did not understand the disease process. The Internet was extremely useful in educating parents and myself regarding the physical and emotional assessment of their child. Also we could print out valuable information and documentation to explain to parents with diagrams and help teach parents about the disorder and what they could expect in the future. I found the Internet to be extremely helpful in ways that books could not.

School children are required to have a complete physical exam prior to starting school. The report is hand written by the physician and turned in by the parent to the school office. . During the school year, the child is only in contact with the school nurse if he/she is sick while in school or if he/she has an accident at school that requires medical intervention. If a child experiences problems after starting school and goes to see the physician, the school is not necessarily aware of what transpires during the visit. I see this as a potential breakdown in communication and a place where informatics could help. For instance, if the parents gave consent to the child’s doctor to release medical information to the school, then the doctor could have ongoing communication with the school nurse. I believe that if the information could be provided electronically, it would make it more convenient for the physician to share the information. Most health care providers are extremely busy and may not be willing to hand write information. With the use of electronics, the doctor could dictate the information for input by a medical assistant. The school nurse could then have easy access to that information. The school nurse could have a database for every child where this information could be stored. I think this information would be especially helpful in assessing/detecting problems associated with hearing. A child who is having difficulty hearing may be mistaken for a child who is having behavioral difficulties. The child may be placed in a special program without identifying the root of the problem. If the child’s complaints are properly identified, then the nurse could tailor her interventions accordingly. The nurse could also use this form of communication to inform the child’s physician of problems that may be initially identified at the school.

Distributed education and distance learning capabilities benefit the health care professional by providing anytime and anywhere high quality learning opportunities. This capability allows hospital personnel to more easily obtain credentials and keep up with continuing education requirements. Distance learning also promotes and facilitates communication among hospital personnel and hospital professionals. Many online resources promote collaboration across disciplines and institutions by facilitating the exchange of peer reviewed educational materials, knowledge, and solutions, which ultimately improve patient care. Additionally, implementation of an e-learning or learning management system enables healthcare organization to provide accessibility, reuse content, and interoperability of learning objects and tracking of learner progress. There is an increasing need for healthcare workers to transfer computer and information management skills to the workplace. The growing use of technologies through distributed education within healthcare professions is due to requirements of maintaining certifications, obtaining continuing education, and completing e-learning competencies. The advantage of distributed education and technology has created a multitude of opportunities for the ongoing development of the adult learner. Distributed education enables the healthcare professional to increase their skills in ongoing lifelong learning, which assists in providing improved patient care, resulting in better health outcomes.

eHealth is the wide range of health care activities involving the electronic transfer of health-related information on the Internet and associated technologies. The use of technology in healthcare improves patient safety, reduces patient hospital visits, saves time of the healthcare professional, and supports individuals to look after themselves. Many studies have proven the vast benefits of eHealth technologies, but many organizations are slow to implement. This is partly due to inefficiencies within an organization’s infrastructure and lack of adequate resources. Implementing effective technologies is often difficult; keeping in mind the complexity revolving around the privacy and security concerns of healthcare consumers. Planning and performing needs assessments are critical and vital to successful outcomes. Although standards have been developed and implemented for formatting health data, organizations still face many issues when implementing interfaces between data systems. eHealth, with its intention of saving time and improving patient safety, still is challenged by the diversity of all consumers of healthcare. There are those who are information literate, with access to online resources, who take an active role in their healthcare. Additionally, there are those consumers who have no access to online information and no knowledge of how to obtain health information. This continues to be a need to promote equity in healthcare services and information access. Learning to access healthcare information will empower each and every healthcare consumer to take control of managing his or her personal health issues. With the known benefits of eHealth and the possibilities of managing one’s own healthcare data, consumers’ expectations of improved accessibility to their health information will drive organizations to enhance their implementation of eHealth technologies.